A landmark report has revealed that Australia's bulk-billing rates have fallen to dangerously low levels while out-of-pocket expenses continue to rise. The Blue Report, compiled by healthcare data company Cleanbill, provides the first nationwide insight into GP billing arrangements over multiple years.
According to the report, the national bulk-billing rate for adult patients at the start of 2025 was just 20.7 per cent, down from 35.1 per cent in 2023. In Tasmania, no clinics are available to bulk-bill adults. New South Wales has the highest rate at 34.5 per cent, followed by Victoria at 19.1 per cent. Over half of the remaining bulk-billing GP clinics are concentrated in NSW, with only NSW, Victoria, and Queensland having rates above 10 per cent.
The decline has had a profound impact on patient behaviour. The Australian Bureau of Statistics reported that the number of Australians avoiding seeing a GP due to cost concerns grew from around 600,000 in 2022 to over 1.5 million in 2024. Out-of-pocket expenses vary, with Tasmania having the highest average at $54 per visit, $7 more than two years ago, while South Australia and Victoria have the lowest at $42.
Cleanbill founder and CEO James Gillespie described the results as concerning but unsurprising, noting that the trend has been consistent over recent years. He highlighted the particularly negative implications for regional Australia, where bulk-billing rates have historically been lower than in cities. Gillespie expressed hope that the geographic data would inform policymakers in Canberra and at state levels to target accessibility of care in regional areas.
